Augmentative and Alternative Communication




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There are many ways people communicate with one another, either verbally or nonverbally. One form of nonverbal communication is through the use of an AAC system. According to the American Speech-Language-Hearing Association, “Augmentative and Alternative Communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas.” AAC is a tool used by children and adults with severe speech and language delays. The function of the AAC system is to “supplement existing speech or replace speech that is not functional,” meaning it assists in improving communication skills.



There are two types of Augmentative and Alternative Communication systems, aided and unaided communication. The first system, aided communication, is a form of communication using facial expressions, gestures, body movement, symbols, pictures, writing, and/or sign language. The second system, unaided communication, requires tools or equipment other than body movements and is technologically advanced. Some examples of an aided system are communication boards and voice output devices. Communication boards are a visual display of language. Each board is unique and specific to every individual and includes the core vocabulary necessary to express their needs and wants. An example of a voice output device is the DynaVox system, a keyboard-based aid, used by individuals with fine literacy skills. Some professionals use low-tech and high-tech as another way to differentiate the two systems. High-tech refers to the use of technology, whereas low-tech does not use technology.

The aided and unaided communication systems are great resources and tools for children with Autism. These forms of communication allow children to express themselves and may also enhance social skills. Currently I am tutoring a six year old boy who was diagnosed with Autism. He is an intelligent young boy but still has difficulties with expressive language. To help improve verbal communication, he uses an unaided communication system, writing. With verbal cues, he is able to write his needs and then can read it aloud. I learned that he is a visual learner and after writing phrases several times, he is able to repeat a phrase without having to look down at the paper. He is an amazing little boy and I am grateful for the opportunity to be his tutor.  Stories like this one are living examples of how children with Autism can still learn and improve their communication skills as long as they have the motivation and support.

Communication Board

DynaVox

Recently, I have gained more interest in learning about AAC. Volunteering in the AAC clinic at San Francisco State University opened up my eyes into a new area of Speech Pathology. I had read about Augmentative and Alternative Communication in my classes, but it is a totally different experience actually working with a client who uses an AAC device. It was definitely a learning experience for me.  It can be very challenging working with a client with this type of device because they may also have other disabilities and disorders other than just speech delay. Clients who use an AAC to communicate usually either have Autism or Cerebral Palsy. The best part about using an AAC device is that it gives a child the opportunity to have a voice, allowing them the ability to interact with others and communicate basic needs and wants. I can see why so many families choose to use these devices based on the many advantages it brings.



                                                                     

References:

• http://www.asha.org/public/speech/disorders/AAC/
• http://www.communicationmatters.org.uk/page/what-is-aac
• http://www.bridgeschool.org/transition/multimodal/com_boards.php
• http://www.ncvital.info/disabilities/speech/voice_output.html

Benefits of Gymnastics

While I was researching more information about children with Autism Spectrum Disorder (ASD), I came across a blog by Jourdan Saunders. The title of the blog post is “Moving Therapy to the Gym: Benefits of Gymnastics for Children with Autism.” Saunders, who has a 23 year background in gymnastics, discusses the advantages of using the sport of gymnastics as an alternative and creative approach for teaching children new skills. In the field of Speech-Language Pathology, professionals are continuously creating and searching for new ideas and strategies to use in therapy sessions. I personally love sports and I agree with Saunders that gymnastics “provides an enriching environment filled with opportunities for sharpening the mind.”

Gymnastics is a combination of athleticism, balance, and coordination. It consists of several events such as the beam, vault, floor, etc. These events can be modified for children with ASD and toward the skill areas they need to work on. For example, to work on social skills the therapist can set up a beam where the children will wait in line until it is their turn, thus practicing turn taking. With the same activity children can also develop and increase their attention span. Focusing on a task can be very difficult for many children with ASD. Creating structured activities, such a walking across the beam, encourages concentration. Children will have to pay close attention to their balance so they do not fall.

      Using gymnastics as an alternated learning experience promotes development of spatial awareness, being aware of your body and its movements. In addition it increases gross motor skills. The therapist could make an obstacle course involving running, jumping, and climbing. To build fine motor skills a ribbon dancing activity can be incorporated. All the activities require the children to listen and follow directions, essential skills in every day life.

I love the idea of using gymnastics as another technique to teach children with ASD. Children are naturally active and being in the same setting each session can be tiring. Switching the therapy to a more stimulating environment may be more motivational.

References:

• http://blog.asha.org/2011/09/06/moving-therapy-to-the-gym-the-benefits-of-gymnastics-for-children-with-autism/

Music Therapy

Music Therapy is becoming very popular and is being used as another approach to improve the skills of children with Autism. The American Music Therapy Association defines Music Therapy as a “clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship.” Music is a form of communication that does not require the involvement of verbal abilities. It is a tool to support individuals with cognitive and emotional challenges.

 Research has provided evidence linking a close connection between music and its effects on the movement of brain waves.  Strong beats cause the brain waves to resonate, sharpening concentration and fine tuning alertness, whereas slower beats help maintain calmness. So why is this important? Well, the change in activity levels caused by the music allows the brain to alter speeds more easily and independently. This alternation of speeds is also a contributor to the effects of breathing and heart rate. Music causes a change in breathing and heart rate similar to the movements in brain waves. The faster the beats the heavier the breathing and the faster the heart rate, while slower beats cause slower breathing and slower heart rate, activating a relaxation response. Music is very beneficial for the overall health and well-being of a person.

 
Music Therapy is a developing technique which is advantageous to increasing individual skills, such as participation and social interactions, lowering anxiety, and increasing the development of new communication abilities. Other results of Music therapy include improvements of sensory issues, behavior, and motor skills. Children with Autism tend to react negatively toward loud noises but by introducing music during a therapy session you can provide the child with techniques to help cope with sound sensitivity.

A Music therapist is very similar to Speech-Language Pathologist. Music therapists are required to assess the potential client, develop a treatment plan, and provide appropriate treatment specific to the client’s needs.  Anyone has the opportunity to become a Music therapist as long as you “earn a bachelor’s degree or higher in music therapy from an American Music Therapy Association (AMTA) approved program.”
 




Music is very diverse and is beneficial for everyone. Personally, I use music as a soothing mechanism for when I am stressed or need a break. For others, they may listen to music to blow off steam or even for motivation when working out. Implementing music within the therapy or classroom is a great teaching technique for children. Children tend to mimic intonations of songs quicker than just listening to someone who speaks in a normal voice. At my work, the speech therapist began to include “circle time” into the daily routine. Not only did the parents love the idea, the children enjoyed music time as well. At times the therapist will introduce instruments and have the children use them while we are singing, bringing in some academic learning and encouraging participation in the activity. I love the whole idea of using music therapy for children with disorders and disabilities. When I become I therapist I will use music as a teaching technique for my clients.

For more information about Music Therapy visit the American Music Therapy Association website.  

References:

• http://autism.about.com/od/autismtherapy101/a/musictherapy.htm
• http://stress.about.com/od/tensiontamers/a/music_therapy.htm
• http://www.musictherapy.org/

Early Intervention Equals Better Communication Skills

As I mentioned before children with Autism have difficulty with verbal communication. Experts are now saying that if children learn verbal skills by the age of five, during adulthood they will be higher functioning than other nonverbal adults who have the disorder. In a 2006 study, toddlers received intensive therapy which focused on “developing fundamental oral language skills.” By the end of the study, the toddlers made a significant increase in their verbal communication.

Connie Kasan of University of California, Los Angeles and her team also conducted a study geared toward increasing verbal communication skills. The study involved 58 children between the ages of three and four. The study focused specifically on two areas of early behavior, symbolic play and joint attention. Kasan and her colleagues randomly separated the children into three groups. Both the symbolic play group and joint attention group geared their sessions toward the assigned behavior, while the control group engaged in free play. Each day the children would play with trained graduate students for a 30 minute intensive intervention.

The study was conducted over a five to six week time period. Before and after each session, the children were evaluated using standardized tests. The tests were a tool used to measure language and cognitive abilities. The children’s play level and diversity, and engagement with caregiver were also observed and noted during each session. At the end of the study the two intervention groups showed great improvements. The symbolic play group had better symbolic behaviors; while the joint attention group increased the usage of pointing behaviors.  

Symblic Play

 
                          Joint Attention

Twelve months after the study was completed; Kasan and her team conducted a follow-up assessment on the children’s language skills. Using a standard language test, the results showed a vast improvement in verbal communication abilities from both the symbolic play group and joint attention group, whereas the control group showed a slight improvement. Kasan believes the most important contributor to such progress was “engaging the child for periods of time with a social partner.”

                These studies are motivational and inspiring. With a great amount of intervention and resources, children with Autism will have the possibility to verbally communicate their needs and want. The findings from the two studies above also proves how early intervention is crucial to help children with disorders. The earlier children receive services, the better off they will be in the future. Having verbal communication skills would also help the struggle of social skills. Children will have the words to interact with their families, friends, and peers.

References:

• http://www.scientificamerican.com/article.cfm?id=early-intervention-autistic-children
• http://www.cde.ca.gov/sp/cd/re/itf09cogdevfdsym.asp
• http://www.relatetoautism.com/index.php?subform=article&article_id=414
  
  

      Overwhelming or uncomfortable situations, for instance a new setting, may cause a child with Autism to revert to repetitive movements, such as rocking. Below are various strategies specific to a classroom environment to help increase the participation of children with Autism.

      A classroom setting can be intimating for some students because it is a new, unfamiliar place and is different than their home environment. Picture the first day of school, as you walk to the school yard there are dozens of children running all over the place. Once you walk into your classroom, you see tables, chairs, materials, books, etc. Even typically developing children get scared and anxious. The role of the teacher is to find ways to ease the anxiety. Participation within the classroom builds a community of learners, that are constantly interacting and exploring. Creating a comfortable and safe learning environment encourages children to participate in conversations and activities. A few simple strategies teachers can use to promote more participation from children with Autism are having a set daily schedule, reducing distractions, and asking simple questions.

     Children with Autism are more successful in predictable situations. An easy way to accommodate this need into the classroom is by creating a written or visual schedule of the daily routine and hanging it either on the board or the wall. This is beneficial for the other children as well as the staff. The teachers may need a reminder of what is coming up next and can use the written schedule as a tool. Students would be able to refer back to the schedule to anticipate or prepare for the next activity. Children with Autism have a difficult time adapting and coping with change. Less surprises equals happy environment.

    
  A large quantity of too much stimulation causes children with Autism to become anxious and lose focus.  The reduction of certain distractions is another strategy that can be applied to the classroom setting. For example, materials could be stored away in cabinets rather than visibly piled up in bins. Display a few pieces of art work at a time, making the walls appear less cluttered. Dimming of lights is another helpful tip; children with Autism tend to fixate on bright lights.  Eliminating as much visual stimulation as possible will help the child’s processing and focusing abilities.


   


     Keeping it simple is the best rule of thumb when working with children with Autism. They have difficulty with comprehending a lot of information at once. Asking simple questions with options, gives the student the opportunity to participate without feeling overwhelmed. It is important for the child to understand you, so while asking questions use familiar vocabulary and encourage eye contact.

      All the strategies listed above can also be applied to the home setting. This will create a consistency between home and school, making it easier for the student to adapt and feel more comfortable.






References:

• http://suite101.com/article/strategies-to-help-autistic-children-in-class-a79634
• http://www.autismhelp.info/childhood/sensory/categories,id,435,1-1.aspx

First off what is a Speech-Language Pathologist (SLP). A SLP, also referred to as a speech therapist, is a person who assesses, diagnose, and treat patients with communication or swallowing disorders. Some of the duties of a SLP are to teach the patient how to produce sounds, teach alternative forms of communication, for example sign language, if patient is unable to produce sounds, and to give guidance to the patient and family on how to cope with the communication disorder. A SLP is not limited to a specific age group. It ranges from children in the School District who may have speech delays to   working in hospitals with the elderly who may have lost their ability to speak due to a stroke.

Now that we know what a SLP does we can change direction and go into more depth about the various patients they work with, more specifically with patients who are diagnosed with Autism. The Children's Hospital of Wisconsin defines Autism as a neurological and developmental disorder. It is the most severe form of Autism spectrum disorder (ASD), which is a range of neurodevelopment disorders.

Common signs of patients with Autism include difficulty with social interactions, limited or no verbal and non-verbal communication, and restricted and repetitive patterns. Difficulty with social interactions includes being unresponsive to others, having the inability to respond to their own name, and avoiding eye contact. Children with Autism often have poor social skills, which inhibits their ability to interpret and understand visual cues, such as facial expressions or tone in voice. Communication is also limited. Children with this disorder refer to themselves by their name rather than using "I" or "me" and some use a singing voice to communicate a small range of topics related to their interests. Common repetitive movements include rocking and twirling. Some children with Autism engage in self-abusive behavior, such as biting or head-banging. Patients may also have an obsession with lining up of objects or toys.

The causes of ASD are not concrete. Studies have suggested that abnormalities of the brain may have influenced a disruption in the brain growth in the early stages of fetal development. Genetics and environment can also be contributing factors.

Some Facts about Autism from Autism Society:

• 1 percent of the population of children in the U.S. ages 3-17 have an autism spectrum disorder
• Prevalence is estimated at 1 in 88 births
• 1 to 1.5 million Americans live with an autism spectrum disorder
• Fastest-growing developmental disability; 1,148% growth rate
• Only 56% of students with autism finish high school

References:

• http://www.chw.org/display/PPF/DocID/22122/router.asp
• http://www.bls.gov/ooh/Healthcare/Speech-language-pathologists.htm#tab-1
• http://www.autism-society.org/about-autism/facts-and-statistics.html

My name is Jeanette Rodriguez. I am currently an Undergrad student at San Francisco State and I am majoring in Communicative Disorders.  I will be starting my second year in the program in the Fall and will hopefully graduate in the Spring. My ambition for after graduation is to attend a Masters Program in California.

 I am currently interning for a Speech and Language Pathologist and love the field. I have learned so much through my internship and would like learn and explore more areas within the field, more specifically, Autism.I have created this blog in hopes to spark the interest of others about Speech Pathology.